2025 CPT code 65150
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Reinsertion of an ocular implant, with or without conjunctival graft.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., modifier 80 for assistant surgeon, modifier AS for other assistants). Always consult with your payer's guidelines before applying modifiers.
Medical necessity is generally established by the clinical need for the procedure based on the patient's medical history.Documentation needs to justify the medical reason for the reinsertion of the implant (e.g., cosmetic improvement, improvement of comfort, prevention of complications).
The ophthalmologist or qualified surgeon is responsible for all aspects of this procedure, including pre-operative assessment, surgical technique, and post-operative care.
In simple words: The doctor puts back an implant in an empty eye socket.A small piece of tissue might be added to close any opening.
This CPT code describes the surgical procedure of reinserting an ocular implant into an empty eye socket.The procedure involves opening the scleral shell (previously closed during evisceration or enucleation), reinserting the implant, and closing the conjunctival membrane over the implant. If necessary, a conjunctival graft is used to repair any defects. The procedure may involve the use of foreign material for reinforcement and/or attachment of muscles to the implant.Surgical assistance may be utilized, requiring appropriate modifier additions based on payer guidelines.
Example 1: A patient underwent enucleation (removal of the eye) several months prior and now requires reinsertion of an ocular implant for cosmetic reasons. The surgeon performs the procedure, including closure of the conjunctival membrane., A patient had a previous evisceration (removal of eye contents). During reinsertion of the ocular implant, a small area of the conjunctiva is found to be missing, necessitating the use of a conjunctival graft for complete closure., A patient who previously had an ocular implant removed requires reinsertion of a new implant.The surgeon uses a surgical assistant during the procedure.Appropriate modifiers are added to the claim to account for the assistant's involvement.
* Preoperative and postoperative evaluations.* Surgical report detailing the procedure (including type of implant, use of graft, and any complications).* Operative notes.* Anesthesia records.* Pathology reports (if applicable).* Imaging studies (if applicable).
** An ocular implant is placed within the muscular cone, while an orbital implant is external to it.This code specifically addresses ocular implants. Always refer to current CPT guidelines and payer-specific policies for the most up-to-date billing and coding information.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- RVU: Refer to the most current Medicare Physician Fee Schedule for RVU and payment information.This will vary based on location and other factors.
- Global Days: Global surgical period information not available in the provided text.Consult current CPT guidelines or payer-specific information.
- Payment Status: Active
- Modifier TC rule: Information on Technical Component (TC) modifier application is not available within the given source data. Consult the current CPT guidelines or payer-specific instructions.
- Fee Schedule: Historical fee schedule information is not provided. Check the CMS website for historical Medicare payment data.
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Office, Inpatient Hospital, Outpatient Hospital